Digestive bleeding and anticoagulation management in times of COVID - 19
Manejo de hemorragia digestiva y anticoagulación en tiempos de COVID - 19
Abstract
Gastrointestinal bleeding (SGI) in patients with SARS-CoV-2 poses unique challenges. Although the results of controlled trials to demonstrate the benefit of empirical anticoagulation are pending, medical centers have proposed intermediate and therapeutic dose anticoagulation, particularly those with elevated D-dimer levels, in order to prevent potentially catastrophic thromboembolic complications. In patients with gastrointestinal bleeding, it is recommended to initiate resuscitation measures, a proton pump inhibitor, and transfusions of blood products and withdrawal of anticoagulants. In suspected bleeding related to portal hypertension, it is recommended to treat according to standard guidelines: resuscitation, splanchnic vasoconstrictor drugs, red blood cell concentrates to maintain a target hemoglobin of 7 to 8 g / dL, proton pump inhibitor administered in form of infusion or injections twice a day, antibiotics as primary prophylaxis, Vitamin K, antifibrinolytics and withdrawal of anticoagulants. Likewise, strict hemodynamic monitoring is suggested for any evidence of persistent bleeding.
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References
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